Prostate Cancer

Question 1

Normal size of prostate gland

Answer 1

walnut

Question 2

make fluid contained in the seminal fluid which nourishes sperm

Answer 2

prostate gland

Question 3

Zone that surrounds proximal urethra

Answer 3

transition

Question 4

Zone that surround ejaculatory ducts

Answer 4

central

Question 5

Zone that surround distal urethra and where most BPH occurs

Answer 5

peripheral

Question 6

Prognosis of prostate cancer

Answer 6

5 yr survival nearly 100%

Question 7

Racial group more often affected by prostate cancer

Answer 7

African Americans

Question 8

Presenting symptoms include increased urinary frequency, painful micturition, decreased stream, hematuria, painful ejaculation

Answer 8

prostate cancer

Question 9

At what level is the PSA when prostate cancer develops

Answer 9

usually above 4

Question 10

Factors that increase PSA

Answer 10

BPH, age, prostatitis

Question 11

Relates PSA level to size of prostate

Answer 11

PSA density

Question 12

Change in PSA over time

Answer 12

PSA velocity

Question 13

low number suggests cancer, since more free PSA from normal prostate is degradated

Answer 13

Free PSA/Total PSA

Question 14

Describe the levels of the Gleason scores

Answer 14

2-4 Best (cells still look normal). 5-7 Intermediate risk. 8-10 Worse (cells have few features of a normal cell and are likely to be aggressive)

Question 15

Therapy for T1a patient

Answer 15

if greater than 60 follow with no therapy

Question 16

Therapy for a T1b, T1c, T2 patient

Answer 16

radical prostatectomy or high dose radiation

Question 17

Therapy for a T3 (stage 3) patient

Answer 17

radiation

Question 18

How long is the average doubling time of a prostate tumor?

Answer 18

slow, 2-4 yrs

Question 19

Nerve sparing procedure. allows neurovascular bundles on either side of prostate that control erectile fxn. Remaining Urethra is sewn to bladder neck over a catheter

Answer 19

Radical Retropubic Prostatectomy (RRP)

Question 20

Whole prostate can be examined histologically.

Surgeon has access to lymph nodes to test if prostate cancer cells have left the tumor. Surgical margin can be examined

Answer 20

Radical Retropubic Prostatectomy (RRP)

Question 21

Cannot access regional lymph nodes. Slight increase in risk of rectal injury and associated complications

Answer 21

Perineal Prostatectomy

Question 22

Radioactive seed implants into prostate. ED less common side effect

Answer 22

brachytherapy

Question 23

Maximize damage to the prostate and minimize damage to surrounding tissues. ED less common side effect

Answer 23

External Beam Radiation

Question 24

initial therapy for locally advanced or metastatic disease

Answer 24

hormonal therapy

Question 25

What hormones do prostate cells and prostate cancer cells depend on for survival and growth?

Answer 25

androgens

Question 26

may be performed prior to prostatectomy or radiation in order to shrink the tumor. standard method of treating advanced and metastatic prostate cancer

Answer 26

androgen ablation therapy (ie hormone therapy)

Question 27

surgical removal of the testicles.

Answer 27

orchiectomy (castration)

Question 28

Name the LHRH analogs

Answer 28

Goserelin (Zolodex)

Leuprolide (Lupron)

Question 29

Name the antiandrogens

Answer 29

Flutamide, bicalutamide, nilutamide

Question 30

Primary value when starting LHRH to limit the flare reaction

Answer 30

antiandrogens

Question 31

Consequences of this treatment include: impotence, decreased libido, hot flashes, weight gain, fatigue, loss of bone/muscle mass

Answer 31

androgen removal

Question 32

Treatment of hormone refractory metastatic disease

Answer 32

Docetaxel (every 3 wks), prednisone, and bisphosphonates

Question 33

Complications of anti-adrogen therapy

Answer 33

diarrhea and hepatic dysfxn

Question 34

5-alpha reductase inhibitor, blocks intracellular conversion of testosterone to dihydrotestosterone

Answer 34

Finasteride